Device for performing a biopsy



Oct. 29, 1940. l H. TURKEL 2,219,605

DEVICE FOR PERFORMING A BIOPSY Filed June 6, 1938 Muse: I

ONE

' Patented Oct. 29, 1940 UNITED STATES PATENT OFFKIE 21 Claims.

examination for determination of; the type of tissue present, such asnormal, cancerous, infected, etc., or in other words, for correctdiagnostic purposes. I

In the past, biopsy always caused the patient pain, bleeding andsoreness, thus very often required anesthesia. Further the existingmethods required surgical preparation for cutting a large area of skin,thus separating the subcutaneous and muscular tissue and then chiselingor gouging out a portion of the bone, or cutting out other deep seatedtissue, resulting frequently in bleed- 5 ing, spreading of infection andscar formation.

My invention consists of a device whereby removal of tissue isaccomplished with the least amount of injury to the superficial and deeptissue, very little or'no pain, practically no bleeding and as a resultpractically no scar is left and only local or no anesthesia is required.

There is a minimum of soreness because only a very small hole is madethrough the tissue. Because of the ease of its manipulation, noassistants or operating room are needed, and biopsy may be done at anydoctors office or in the patients home or bedside without anypreparation.

In the case of removal of purulent material (pus) from infected tissue,it is impossible for the pus to spread and infect nearby tissue. This isaccomplished because of the outer tube which protects the surroundingtissue from contamination and the inner tube through which the infectedmaterial is carried out either by direct removal, suction or irrigation.

My improvement provides an easy means of withdrawing specimens deepseated or superficial, soft or hard, like bone, fat, muscle, etc., oreven liquid material for gross or microscopic examination.

For an understanding of my invention, reference should be had to theappended drawing of which:

Figure 1 in an elevational view of the external needle.

Figure 1a is a plan-view of the same.

Figure 2 is an elevational view of the stylet of the external needle.

Figure 2a is a plan-view of the same.

Figure 3 is an elevational view of the internal needle.

Figure 3a is a plan-view of the same.

Figure 4 is an elevational view of the stylet of 6 the internal needle.

Figure 4a is a plan-view of the same.

Figure 5 is a partially sectioned view of the interior grinding needlewith handle attached.

Figure 6 shows plan views of two possibletypes of grinding edges for theinternal needle. 5

Figure '7 is a section segment of the internal cutting needleillustrating the conical interior of its end.

Figures 8A, 8B, 8C, 8D, 8E, 8F, 8G are elevational views illustratingthe operation of my de- 10 vice step by step as described in theaccompanying specification.

My device is comprised of five parts: an external guiding, leading, andprotecting hollow needle I, of Fig. 1, of any desired length, the end 52 of which is sharp coming to a point on the outside edge of the needle,the end of the needle having been cut on an oblique angle. The needlehas a hollow head 3 with which it can be manipulated or to which alarger handle 2| of any 20 desirable size or shape may be separatelyattached. The head is also provided with indicating means 4 later to beexplained.

The stylet 5, in Fig. 2, for the external needle I is designed to fitwithin the latter, the head 6 of the 25 stylet with a projection orstopper being so designed with a neck I as to be received and held bythe head 3 of the hollow needle, as in Fig. 8A. The head by which thestylet can be manipulated is so designed that if desired a large handle2| 30 may be attached in order to obtain additional leverage. The headof the stylet 5 is provided with a means 8 designed to cooperate withthe indicating means 4 above mentioned in the head of the hollowexternal needle I. The pointed-35 end 9 of the stylet is also cutobliquely so that when the stylet is inserted within the hollow externalneedle, the end 9 of the stylet cooperates with the end 2 of the hollowneedle in order to prevent improper cutting of the tissue when the 40external needle I is inserted.

The hollow internal or cutting needle I0, of Fig. 3, whose diameter isequal to that of the stylet of the external-needle, is designed to beslipped within the external needle I after the 45 stylet 5 is removed.Similarly, the hollow head II of the internal needle I0 is designed witha neck I2 or other cooperating means so as to be received by the hollowhead 3 of the external needle, as in Fig. 8D.. The lengths of the two soneedles may be varied but the relation must be such that the internalneedle I0 is longer but narrower than the external needle I. Theinternal needle III is provided with a cutting edge I3 upon its end. Thedesign of the end I3 01' the .55

internal needle and the design of the cutting edge or teeth, as in Fig.6, may be of different types depending upon what type of tissue issought to be removed or drilled into, or depending upon whether hard,soft, or liquid matter is to be removed.

For hard tissue such as bone, the inside surface I3a of the end I3 ofthe internal needle I0 is cone shaped or otherwise converging; Fig. 7,so that hard tissue once wedged into the end of the needle after beingcut by the cutting edge of the hollow needle can be removed along withthe removal of the needle itself. Experience in the past has shown thatwith a purely hollow cylindrical interior, the cut tissue would slipaway from the hollow needle and could not be removed; but for removingsoft tissue such as portions of a breast tumor or cancerous growth, acylindrical interior of the hollow needle is adequate. Also, the lattertype is adequate for the removal of liquids such as pus, blood or forirrig'ation purposes. The hollow needle may be so designed as to allowthe removal of as large a sample of tissue as is desired. The head IIbeing used to manipulate the cutting needle is so designed that a largerhandle may be attached for manipulating the hollow needle. A suctionadapter or syringe 23 may be inserted either directly or through thelarge handle 2| into the head I I of the internal needle I0. Further,the head II of the hollow needle I0 is provided with an indicating meansI4 similar to 4 on the head of the external needle I. The neck I2 andthe portion of the needle directly below is provided with a graduatedscale I5 so that one may determine how deeply the needle has beeninserted into the tissue; and also for determining how deep to go intothe tissue.

A stylet I6 with a flat bottom I! designed to be received within theinternal needle I0 for forcing out or expelling the tissue held in theend I3 once it had been cut so that the sample may be examined. Thisstylet I6 is also provided with a head I8 for manipulating the same orto be attached to a larger handle 2I, the head I8 to be received withinthe bottom opening of the handle M. The head ll of the stylet I6 is alsoprovided with a means I9 similar to 8 on the other stylet 5 designed tocooperate with the indicating means I4 above mentioned in the head II ofthe internal needle III. The neck 20 is designed so as to be receivedwithin the hollow head II. The length of the stylet I6 is such that whenit is inserted within the internal needle, the end H of the former I5reaches the and I3 01 the internal needle so that any tissue accumulatedin the end of the needle may be pushed out. The inventor does not limithimself to the use of square heads, for any other shaped head ispracticable; but it is believed that the squar head embodiment ispreferable.

A handle 2| is provided to facilitate the use of I, 5, I0 and I5. Thehandle may be of variable shapes designed with an opening in its bottomto loosely lit the heads of all needles and stylets so that they can beeasily pushed through or turned in the tissue or for the grinding ofbone by means of the added leverage, and at the same time the handleitself is easily removable.

The handle may be transparent or provided with a reading slot 22 so thatif a glass extension or syringe is inserted in the opening providedtherein and connected to the head of the internal needle the presence ofliquid may be detected.

To facilitate drilling into hard bone, a hand tissue or deep tissue, butby using the above de-.

scribed handle of my invention, pushing the needle through deep tissueand bone tissue or grinding therein is facilitated.

Operation Removal of tissue specimens living or dead, normal orabnormal. is accomplished with my novel invention by the insertiontogether of the external needle I and its corresponding stylet 5 intothe tissue until the points of both as in Fig. 8A reach that portion ofthe body wherefrom it is desired to remove a specimen for microscopicexamination. It is to be noted that this operation is accomplished withthe head 5 of the stylet 5 tight within the head of the external needle;and likewise the ends 9 and 2 of the stylet and the external needlecooperate with each other so that the oblique plane upon which thestylet is cut corresponds with the oblique plane on which the end of theexternal needle is cut. By this means, the tissue is separated and notcut out of the patient when the needle is inserted.

The next operation Fig. 8B is to remove only the stylet 5 and insert, asin Figure 80, the hollow internal grinding needle I0 within the externalneedle I. The internal needle Fig. 8D manipulated by twisting the handlecuts out as much of the desired specimen of tissue as is needed, whichtissue as it is out proceeds up into the end I3 within the hollowinternal needle I0. Figure 8E shows the outer needle pushed further inso that the external tissue near the end of I3 will not press upon theinternal drilled core and thus prevent it from coming out of the bodywhen I0 is removed. The specimen is then withdrawn by removing theinternal needle I0. In the case where it is desired to remove pus, bloodor other liquid, the head II of the needle I0 is so designed as toreceive a syringe or suction adapter 23.

The stylet I5 is designed to fit into the internal needle I0 and when soinserted will cause the expelling of the desired specimen from theneedle for examination.

Figure 8F shows the external needle remaining in the tissue. Before thisis removed, the stylet 5 must again be inserted, Figure 8G, and the two,i. e., I and 5 removed together. This prevents the escape of pus orblood preventing the spread of any infection, because the tissueseparated by the initial operation of the external needle elasticallycloses as I and 5 are removed closing up the hole and holding back anyremaining liquids.

. Now having described the invention hereof, reference will be had tothe claims which follow:

I claim:

1..A device for the removal of tissue from a body, comprised of anexterior guiding and projecting hollow pointed needle, the end of whichis cut on an angle, a hollow head thereon, indicating means in the topof the head; a stylet or solid pointed needle, the end of which is cuton an oblique angle, the outside diameter of the stylet being smallerthan the interior diameter of the external needle, a solid head thereon,cooperating means which will fit within the hollow head of the externalneedle, means on the neck thereof to cooperate with the indicating meanson the head of the external needle; and a hollow pan internal needlehaving a hollow head adapted to fit within the hollow head of saidexternal needle, said needle having an outside diameter substantiallyequal to that of the stylet whereby it forms a snug fit in the bore ofsaid external needle and an internal bore, the outer end of saidinternal bore flaring outwardly whereby a tapered recess is formedtherein.

2. A device for the removal of tissue from a body, comprised of anexterior guiding and projecting hollow pointed needle, the end of whichis cut on an angle, a hollow head thereon, indicating means in the topof,the head; a stylet or solid pointed needle, the end of which is cuton an angle, the outside diameter of the stylet being smaller than theinterior diameter of the external needle, a solid head forming acooperating means which will fit within the hollow head of the externalneedle, means on the neck there of to cooperate with the indicatingmeans on the head of the external needle; a hollow internal needlehaving a hollow head adapted to fit within the hollow head of saidexternal needle, said needle having an outside diameter substantiallyequal tothat of the stylet whereby it forms a snug fit in the bore ofsaid external needle, and an internal bore, the outer end of saidinternal bore flaring outwardly whereby a tapered recess is formedtherein; a handle provided with a reading slot, an opening in the bottomadapted to loosely fit upon the heads of the needles and stylet, anopening extending vertically through the handle within which may beinserted a glass extension or syringe.

3. In combination with a device for the removal of tissue from a body,comprised of a hollow needle, a hollow head on the inner end thereof anda cutting means on the outer end thereof, indicating means in the topthereof, a calibrated scale upon the neck and upper part of the needle,an inwardly converging interior on said outer end; a solid. stylet orneedle with a flat end,

designed to fit within the cutting needle, a solid head thereon,cooperating means which will fit within the hollow head of the cuttingneedle, and means upon the neck thereof to cooperate with the indicatingmeans in the head of, said cutting needle.

4. In combination with a device for the removal of tissue from a body,comprised of an exterior guiding and projecting hollow pointed needle,the end of which is cut on an angle, a hollow head thereon, indicatingmeans in the top of the head; and a hollow internal needle, a hollowhead on the inner end thereof and a cutting means on the outer endthereof, indicating means in the top thereof, cooperating means whichwill fit within the hollow head of the external needle, a calibratedscale upon the neck and upper part of the needle, and an inwardlyconverging interior on the said outer end.

5. A hollow guiding needle for piercing" and separating tissue, a hollowneedle slidably disposed therein, having upon its outer end a cuttingedge and corresponding therewith an inwardly converging interior, withinwhich cut tissue may be wedged for removal, said exterior needlerelieving the cut tissue specimen from the pressure of surroundingtissue to facilitate its removal, said interior needle also providing achannel for the passage of purulent material.

6. A device for the removal of tissue from a body comprised of a hollowneedle, a hollow head on the inner end thereof and a cutting means onthe outer end thereof, and an inwardly concating means in the top of thehead; a hollow internal needle, a hollow head on the inner end thereofand a cutting means on the outer end thereof, indicating means in thetop thereof, cooperating means which will fit within the hollow head ofthe external needle, an inwardly converging interior on said outer end;and a handle provided with a reading slot, an opening in the bottom ofthe handlewhich will loosely fit upon the heads of the needles, anopening extending.

vertically through the handle within which may be inserted a glassextension or syringe.

8. A device for the removal of tissue from a body, comprised of a hollowneedle, a hollow head on the inner end thereof and a cutting means I onthe outer end thereof, an inwardly converging interior on said outerend; and a handle, provided with a reading slot, an opening in thebottom of the handle which will loosely fit upon the head of the needle,an opening extending vertically through the handle within which may beinserted a glass extension or syringe.

9. A device for the removal of tissue from a body, comprised of a hollowneedle, a hollow head on the inner end thereof and a cutting means onthe outer end thereof, an inwardly converging interior on said outerend.

10. In combination with a device for the removal of tissue from a body,comprised of an exterior guiding and projecting hollow pointed needle,the end of which is cut on an angle, a hollow head thereon, indicatingmeans in the top of the head; and a hollow internal needle, a hollowhead on the inner end thereof with a cutting means on the outer endthereof, indicating means in the top thereof, cooperating means whichwhich will fit within the hollow head of the external needle, aninwardly converging interior on the cutting end thereof; a solid styletor needle with a flat end, designed to fit withinthe internal needle, asolid head thereon, cooperating means'which will fit within the hollowhead of the interior cutting needle, and means upon the neck thereof tocooperate with the indicating means in the head of the interior needle.

11. A device as set forth in claim 1, said hollow internal needle havinga cutting means at its outer end.

12. A biopsy specimen needle comprising a head member on its inner endand a hollow shank 15. A biopsy punch comprising a shaft whose piercingend is beveled completely around its periphery, said piercing end havinga larger aperture at its extremity than the main bore of the shaft.

16. A biopsy punch comprising a shaft having a piercing end which isbeveled, and slopes inwardly, and a head for said shaft which is knurledto enable quick rotation of the entire punch.

17. A biopsy punch comprising a hollow shaft having a piercing end whichslopes inwardly, and a removable stylet for said punch having a sharpend adapted to protrude beyond the piercing end of said shaft.

18. A device for the removal of tissue from a body comprising a hollowneedle having a piercing end, said end having an inwardly converginginterior.

19. A biopsy punch comprising a combination of an exterior guidinghollowneedle, the ehdoi which is cut on an angle, a hollow head thereon; asolid headed needle with its end cut on an angle, adapted to beremovably inserted within said exterior needle; and a hollow internalneedle 20 having a hollow head adapted to removably fit withinsaidexterior needle. the other end of said internal needle flaringoutwardly to form a tapered recess.

20. A biopsy punch comprising a combination of an exterior guidinghollow needle, a hollow head thereon; a solid headed needle adapted tobe removably inserted within said exterior needle; and a. hollowinternal needle having a holv.low head adapted to removably fit withinsaid exterior needle, the outer end of said internal needle flaringoutwardly to form a tapered recess.

21. The combination of an exterior guiding hollow needle having a hollowhead; a hollow internal needle with a hollow head, adapted to removablyfit within said guide needle, having cutting means on the outer endthereof; and a headed solid needle adapted to be removably insertedwithin said internal needle.

HENRY 'I'URKEL.

